Emura Kenji, Nitta Ryo, Arakawa Takamitsu
Faculty of Rehabilitation, Shijonawate Gakuen University, Daito, Japan.
Division of Structural Medicine and Anatomy, Department of Physiology and Cell Biology, Kobe University Graduate School of Medicine, Kobe, Japan.
Clin Anat. 2025 Oct;38(7):740-747. doi: 10.1002/ca.24209. Epub 2024 Aug 14.
The sternoclavicular joint (SCJ) functions as the basal joint of the entire upper limb and must move in the proper pattern for normal scapular motion. Afferent sensations from joints, such as proprioception and pain sensation, are important for maintaining the proper motion and condition of joints. Detailed anatomical data are useful for discussing injuries or surgeries that impair the afferent nerve to the SCJ. Nerve branches to SCJs were examined on 12 sides, and the subclavian nerve was investigated on six sides to clarify whether it innervates this joint. On seven of the 12 sides, the SCJ was innervated by two nerves, (1) a branch from the medial supraclavicular nerve that ran medially along the clavicle and (2) a branch from the lateral pectoral nerve that innervated the clavicular head and upper part of the sternocostal head of the pectoralis major. This branch ran medially behind the clavicular head of the pectoralis major and reached the SCJ. In the remaining five sides, the SCJ was innervated solely by the branch from the medial supraclavicular nerve. Subclavian nerves ended within the subclavius muscle or periosteum of the clavicle and were separate from the SCJs. Our data on the route of nerve branches to the SCJ suggest that injury or surgery, such as clavicle fracture or resection of the clavicular head of the pectoralis major for myocutaneous flap transfer, can impair the SCJ's afferent nerve supply.
胸锁关节(SCJ)作为整个上肢的基础关节,其运动模式必须正常,才能保证肩胛骨的正常运动。关节的传入感觉,如本体感觉和痛觉,对于维持关节的正常运动和状态至关重要。详细的解剖学数据有助于探讨影响胸锁关节传入神经的损伤或手术。对12侧胸锁关节的神经分支进行了检查,并对6侧的锁骨下神经进行了研究,以明确其是否支配该关节。在12侧中的7侧,胸锁关节由两条神经支配:(1)一条来自锁骨上内侧神经的分支,沿锁骨内侧走行;(2)一条来自胸外侧神经的分支,支配胸大肌的锁骨部和胸肋部的上部。该分支在胸大肌锁骨部后方内侧走行,到达胸锁关节。在其余5侧,胸锁关节仅由锁骨上内侧神经的分支支配。锁骨下神经在锁骨下肌或锁骨骨膜内终止,与胸锁关节分开。我们关于胸锁关节神经分支走行的数据表明,锁骨骨折或为肌皮瓣转移而切除胸大肌锁骨部等损伤或手术,可能会损害胸锁关节的传入神经供应。